摘要

Objectives: This study provides clinical and ultrasound-based insights into the behavior of CaHA combined with polymicronutrients for hand rejuvenation. The analysis focuses on treatment optimization, including dilution techniques, ultrasound findings, and the role of polymicronutrients in collagen stimulation and extracellular matrix remodeling. Introduction: Hand rejuvenation has become an increasingly popular aesthetic procedure to restore volume loss and improve skin quality. Calcium hydroxylapatite (CaHA) is a well-established filler and biostimulator, while polymicronutrient serums provide essential cofactors for extracellular matrix remodeling. Combining these treatments may enhance rejuvenation outcomes. Materials / method: This prospective, split-hand, double-blind, randomized controlled study included 22 individuals aged 35–65 years with moderate to severe hand aging (Hand Grading Scale 2–4). Each participant received a single session of subdermal injection with 30% calcium hydroxylapatite (CaHA) diluted in a polymicronutrient serum on one hand, while the contralateral hand was treated with CaHA diluted in 2% lidocaine. The study was approved by an Ethics Committee and conducted according to Good Clinical Practice (GCP) guidelines. Outcomes were assessed at baseline, day 15, and day 90, including photographic d Results: Both treatments led to significant improvements in skin volume and quality, as assessed by ultrasound imaging and GAIS scores. At 90 days, 63% of treated hands showed improvement based on HGS and GAIS. No significant difference was observed between treatments regarding efficacy. Both approaches demonstrated a high safety profile, with no serious adverse events reported. One case of local infection was successfully managed with oral antibiotics. Conclusion: Both CaHA dilutions were effective in enhancing dermal and subcutaneous tissue structure, improving skin thickness. However, at the tested dilution ratio (1:1), the addition of polymicronutrients did not result in significantly superior outcomes compared to conventional CaHA-lidocaine dilution. Further research is needed to optimize concentration and evaluate long-term collagen remodeling effects.